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Brady MB, VonVille HM, White JF, Martin EM, Raabe NJ, Slaughter JM, Snyder GM. Transmission visualizations of healthcare infection clusters: A scoping review. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e92. [PMID: 36483443 PMCID: PMC9726548 DOI: 10.1017/ash.2022.237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To evaluate infectious pathogen transmission data visualizations in outbreak publications. DESIGN Scoping review. METHODS Medline was searched for outbreak investigations of infectious diseases within healthcare facilities that included ≥1 data visualization of transmission using data observable by an infection preventionist showing temporal and/or spatial relationships. Abstracted data included the nature of the cluster(s) (pathogen, scope of transmission, and individuals involved) and data visualization characteristics including visualization type, transmission elements, and software. RESULTS From 1,957 articles retrieved, we analyzed 30 articles including 37 data visualizations. The median cluster size was 20.5 individuals (range, 7-1,963) and lasted a median of 214 days (range, 12-5,204). Among the data visualization types, 10 (27%) were floor-plan transmission maps, 6 (16%) were timelines, 11 (30%) were transmission networks, 3 (8%) were Gantt charts, 4 (11%) were cluster map, and 4 (11%) were other types. In addition, 26 data visualizations (70%) contained spatial elements, 26 (70%) included person type, and 19 (51%) contained time elements. None of the data visualizations contained contagious periods and only 2 (5%) contained symptom-onset date. CONCLUSIONS The data visualizations of healthcare-associated infectious disease outbreaks in the systematic review were diverse in type and visualization elements, though no data visualization contained all elements important to deriving hypotheses about transmission pathways. These findings aid in understanding the visualizing transmission pathways by describing essential elements of the data visualization and will inform the creation of a standardized mapping tool to aid in earlier initiation of interventions to prevent transmission.
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Affiliation(s)
- Mya B. Brady
- Department of Infection Prevention and Control, UPMC Presbyterian–Shadyside, Pittsburgh, Pennsylvania
- Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Helena M. VonVille
- University of Pittsburgh Health Sciences Library System, Pittsburgh, Pennsylvania
| | - Joseph F. White
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania
| | - Elise M. Martin
- Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Veterans’ Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Nathan J. Raabe
- Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania
| | - Julie M. Slaughter
- Department of Infection Prevention and Control, UPMC Presbyterian–Shadyside, Pittsburgh, Pennsylvania
| | - Graham M. Snyder
- Department of Infection Prevention and Control, UPMC Presbyterian–Shadyside, Pittsburgh, Pennsylvania
- Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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A Modern Perspective on Vaccinating Healthcare Service Providers in India: A Narrative Review. Infect Dis Ther 2021; 11:81-99. [PMID: 34773563 PMCID: PMC8590119 DOI: 10.1007/s40121-021-00558-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/21/2021] [Indexed: 10/28/2022] Open
Abstract
Healthcare providers (HCPs) are at increased risk of acquisition and transmission of infectious disease. Vaccinating HCPs is an essential preventive measure to protect them and their patients against communicable diseases, while positively and directly impacting the functioning of the healthcare system. In India, healthcare represents one of the largest employment sectors with 3.8 million HCPs; however, there is limited awareness of national immunisation guidelines for the Indian HCP population. Data from communicable disease outbreaks across India suggest inadequate vaccination rates amongst HCPs; studies have reported influenza and varicella vaccination rates as low as 4.4% and 16%, respectively. In this review, we discuss data highlighting the impact of insufficient vaccination coverage, barriers to vaccination, and the lack of immunisation guidelines amongst HCPs in India. COVID-19 vaccination programmes for HCPs have been critical in slowing the pandemic in India. This provides an opportunity to raise awareness about the importance of vaccines amongst HCPs in India.
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Gaitan Gomez OL, Aristizabal P, Bueno Robles LS. Práctica de inyecciones seguras por parte del personal de la salud: revisión integrativa. INVESTIGACIÓN EN ENFERMERÍA: IMAGEN Y DESARROLLO 2020. [DOI: 10.11144/javeriana.ie22.pisp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Introducción: Las prácticas de inyecciones seguras han recobrado importancia en las últimas dos décadas, como consecuencia de las infecciones asociadas con su aplicación incorrecta. Objetivo: Analizar la evidencia disponible sobre las prácticas de inyecciones seguras ejecutadas por el personal de la salud en su práctica clínica. Método: Revisión integrativa de la literatura, realizada en 12 bases de datos entre 1999 y 2018. Resultados: Se seleccionaron 29 artículos y se identificaron prácticas riesgosas como el reúso de los dispositivos de inyección en el mismo paciente o en otros, fallas en la técnica aséptica, ausencia o no seguimiento del protocolo posexposición, reencapuchado de la aguja y ausencia de inmunización contra el virus de hepatitis B. Conclusiones: Los esfuerzos orientados a la seguridad del paciente deben enfocarse también en acciones concretas dirigidas a la administración de los medicamentos.
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Tavoschi L, Quattrone F, Agodi A, Lopalco PL. Risk of transmission of vaccine-preventable diseases in healthcare settings. Future Microbiol 2019; 14:9-14. [PMID: 31210537 DOI: 10.2217/fmb-2018-0236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The transmission of infectious agents within healthcare settings is a priority public health problem. Although the main burden of healthcare-associated infections is commonly caused by Gram-negative bacteria and fungi, vaccine-preventable diseases represent an additional infectious risk for patients attending healthcare facilities. Hepatitis B, rotavirus gastroenteritis, influenza, measles, pertussis and pneumococcal and meningococcal invasive bacterial infections still represent a threat, notwithstanding the presence of universal vaccination programs. For this reason, healthcare worker immunization is an important strategy to limit the risk of vaccine-preventable diseases in such a fragile population.
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Affiliation(s)
- Lara Tavoschi
- Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
| | - Filippo Quattrone
- Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
| | - Antonella Agodi
- Department of Medical & Surgical Sciences & Advanced Technologies 'GF Ingrassia', University of Catania, via S. Sofia, 87, 95123, Catania, Italy
| | - Pier L Lopalco
- Department of Translational Research & New Technologies in Medicine & Surgery, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
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Büchner A, Du Plessis NM, Reynders DT, Omar FE, Mayaphi SH, Haeri Mazanderani AF, Avenant T. Nosocomial outbreak of hepatitis B virus infection in a pediatric hematology and oncology unit in South Africa: Epidemiological investigation and measures to prevent further transmission. Pediatr Blood Cancer 2015; 62:1914-9. [PMID: 26047015 DOI: 10.1002/pbc.25605] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 04/28/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hospital-acquired hepatitis B virus (HBV) infection has been well described and continues to occur worldwide. Recent nosocomial outbreaks have been linked to unsafe injection practices, use of multi-dose vials, and poor staff compliance with standard precautions. This report describes a nosocomial outbreak that occurred in a pediatric hematology and oncology unit of a large academic hospital, the epidemiological investigation of the outbreak, and preventive measures implemented to limit further in-hospital transmission. METHODS Outbreak investigation including contact tracing and HBV screening were initially carried out on all patients seen by the unit during the same period as the first three cases. Routine screening for the entire patient population of the unit was initiated in February 2013 when it was realized that numerous patients may have been exposed. RESULTS Forty-nine cases of HBV infection were confirmed in 408 patients tested between July 2011 and October 2013. Phylogenetic analysis of the HBV preC/C gene nucleotide sequences revealed that all tested outbreak strains clustered together. Most (67%) patients were HBeAg positive. The cause of transmission could not be established. Preventive measures targeted three proposed routes. HBV screening and vaccination protocols were started in the unit. CONCLUSIONS The high number of HBeAg positive patients, together with suspected lapses in infection prevention and control measures, are believed to have played a major role in the transmission. Measures implemented to prevent further in-hospital transmission were successful. On-going HBV screening and vaccination programs in pediatric hematology and oncology units should become standard of care.
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Affiliation(s)
- Ané Büchner
- Paediatric Haematology and Oncology Unit, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Nicolette M Du Plessis
- Paediatric Infectious Diseases Unit, Kalafong Provincial Tertiary Hospital, University of Pretoria, Pretoria, South Africa
| | | | - Fareed E Omar
- Paediatric Haematology and Oncology Unit, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Simnikiwe H Mayaphi
- Department of Medical Virology, University of Pretoria and National Health Laboratory Service, Tshwane Academic Division, Pretoria, South Africa
| | - Ahmad F Haeri Mazanderani
- Department of Medical Virology, University of Pretoria and National Health Laboratory Service, Tshwane Academic Division, Pretoria, South Africa
| | - Theunis Avenant
- Paediatric Infectious Diseases Unit, Kalafong Provincial Tertiary Hospital, University of Pretoria, Pretoria, South Africa
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Kliner M, Dardamissis E, Abraham KA, Sen R, Lal P, Pandya B, Mutton KJ, Wong C. Identification, investigation and management of patient-to-patient hepatitis B transmission within an inpatient renal ward in North West England. Clin Kidney J 2015; 8:102-6. [PMID: 25713718 PMCID: PMC4310432 DOI: 10.1093/ckj/sfu130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 11/07/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Transmission of hepatitis B virus (HBV) is rare within healthcare settings in developed countries. The aim of the article is to outline the process of identification and management of transmission of acute hepatitis B in a renal inpatient ward. METHODS The case was identified through routine reporting to public health specialists, and epidemiological, virological and environmental assessment was undertaken to investigate the source of infection. An audit of HBV vaccination in patients with chronic kidney disease was undertaken. RESULTS Investigations identified inpatient admission to a renal ward as the only risk factor and confirmed a source patient with clear epidemiological, virological and environmental links to the case. Multiple failures in infection control leading to a contaminated environment and blood glucose testing equipment, failure to isolate a non-compliant, high-risk patient and incomplete vaccination for patients with chronic kidney disease may have contributed to the transmission. CONCLUSIONS Patient-to-patient transmission of hepatitis B was shown to have occurred in a renal ward in the UK, due to multiple failures in infection control. A number of policy changes led to improvements in infection control, including reducing multi-function use of wards, developing policies for non-compliant patients, improving cleaning policies and implementing competency assessment for glucometer use and decontamination. HBV vaccination of renal patients may prevent patient-to-patient transmission of HBV. Consistent national guidance should be available, and clear pathways should be in place between primary and secondary care to ensure appropriate hepatitis B vaccination and follow-up testing.
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Affiliation(s)
- Merav Kliner
- Cheshire and Mersey Health Protection Team, Public Health England, Liverpool, UK
| | - Evdokia Dardamissis
- Cheshire and Mersey Health Protection Team, Public Health England, Liverpool, UK
| | - K. Abraham Abraham
- Aintree University Hospitals NHS Trust and Liverpool Hope Hospital, Liverpool, UK
| | - Rachel Sen
- Aintree University Hospitals NHS Trust and Liverpool Hope Hospital, Liverpool, UK
| | - Pankaj Lal
- Aintree University Hospitals NHS Trust and Liverpool Hope Hospital, Liverpool, UK
| | - Bhavna Pandya
- Aintree University Hospitals NHS Trust and Liverpool Hope Hospital, Liverpool, UK
| | | | - Christopher Wong
- Aintree University Hospitals NHS Trust and Liverpool Hope Hospital, Liverpool, UK
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Loulergue P, Launay O. Vaccinations among medical and nursing students: Coverage and opportunities. Vaccine 2014; 32:4855-9. [DOI: 10.1016/j.vaccine.2014.01.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Revised: 12/27/2013] [Accepted: 01/05/2014] [Indexed: 10/25/2022]
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Sauerbrei A. Is hepatitis B-virucidal validation of biocides possible with the use of surrogates? World J Gastroenterol 2014; 20:436-444. [PMID: 24574712 PMCID: PMC3923018 DOI: 10.3748/wjg.v20.i2.436] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 09/30/2013] [Accepted: 11/30/2013] [Indexed: 02/06/2023] Open
Abstract
The hepatitis B virus (HBV) is considered to be a major public health problem worldwide, and a significant number of reports on nosocomial outbreaks of HBV infections have been reported. Prevention of indirect HBV transmission by contaminated objects is only possible through the use of infection-control principles, including the use of chemical biocides, which are proven to render the virus non-infectious. The virucidal activity of biocides against HBV cannot be predicted; therefore, validation of the virucidal action of disinfectants against HBV is essential. However, feasible HBV infectivity assays have not yet been established. Thus, surrogate models have been proposed for testing the efficacy of biocides against HBV. Most of these assays do not correlate with HBV infectivity. Currently, the most promising and feasible assay is the use of the taxonomically related duck hepatitis B virus (DHBV), which belongs to the same Hepadnaviridae virus family. This paper reviews the application of DHBV, which can be propagated in vitro in primary duck embryonic hepatocytes, for the testing of biocides and describes why this model can be used as reliable method to evaluate disinfectants for efficacy against HBV. The susceptibility levels of important biocides, which are often used as ingredients for commercially available disinfectants, are also described.
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Kaslow RA. Epidemiology and Control: Principles, Practice and Programs. VIRAL INFECTIONS OF HUMANS 2014. [PMCID: PMC7122560 DOI: 10.1007/978-1-4899-7448-8_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Infectious disease epidemiology is concerned with the occurrence of both infection and disease in populations and the factors that determine their frequency, spread, expression and distribution. Viruses show characteristic infectivity, virulence and pathogenicity. The most well established host factors are age, sex and race, but other host biological and behavioral factors affect acquisition of viral infection and/or its course and manifestations. The physical, chemical and biological environment operates on the virus itself and may also alter the host biological or behavioral response. Viral infections have incubation periods lasting days or weeks, while their pathologic sequelae may not manifest for years or decades. Likewise the degree or intensity of host response and clinical expression may range from largely inapparent to highly lethal. The degree of cell, tissue and organ specificity is high. Common syndromes involve the respiratory, gastrointestinal, and central nervous systems, the liver, and mucocutaneous surfaces. Vertical transmission may produce a variety of congenital and perinatal conditions. Viruses spread by multiple modes, using nearly every bodily surface or fluid as a route of exit or entry, either by direct contact or indirectly through an animal vector or other inanimate vehicle. Different viral Infections occur nearly ubiquitously or sporadically; they may be present continuously throughout a population (endemic) or occur in seasonal rhythm or in unexpectedly explosive form (epidemic). Many viruses are refractory to all known therapeutic agents, while for a few, the increasing number of highly effective agents holds great promise. Vaccines have produced many historical successes including the ultimate goal of eradication, but many viral infections continue to elude effective vaccine development. Major government and private sector programs for treatment and prevention have raised expectations of successful control for certain widespread and serious viral diseases; however, in every case a unique set of scientific, socioeconomic, political and behavioral barriers remains to be overcome.
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Curran ET. Outbreak column 4: an ‘infection control never event’ – nosocomial bloodborne virus outbreak. J Infect Prev 2012. [DOI: 10.1177/1757177412455444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Response: Providing strong evidence of nosocomial outbreak of hepatitis B virus infection. J Hosp Infect 2012. [DOI: 10.1016/j.jhin.2011.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Amini-Bavil-Olyaee S, Maes P, Van Ranst M, Pourkarim MR. Providing strong evidence of nosocomial outbreak of hepatitis B virus infection. J Hosp Infect 2012; 80:269-70; author reply 270-2. [PMID: 22245118 DOI: 10.1016/j.jhin.2011.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 10/14/2011] [Indexed: 12/23/2022]
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